Comput. Aided Surg. - Morphometric analysis of anatomical implant forms for minimally invasive acetabular fracture osteosynthesis.

Tópicos

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Resumo

TRODUCTION: Anatomical implants enable minimally invasive osteosynthesis (MIO) and represent ideal complements of computer-assisted surgical workflows. This 3D morphometric study analyzes anatomical implant forms (AIF) for acetabular fracture osteosynthesis (AFO).MATERIALS AND METHODS: Three-dimensional pelvis models were created from clinical CT data of 99 European-Caucasian patients (50 females, 49 males). The mean age of the patients was 60.1 years (range: 20-89; SD 10.8). Definition of a referential region of interest (ROI) corresponding to an AIF for AFO was followed by automated ROI computation for each of the 198 hemipelvises. Three-dimensional statistical modeling and analysis of the resulting 198 homologous ROIs consisted of thin-plate spline transformation, generalized Procrustes fit, and principal component analysis.RESULTS: The mean ROI length was 18.2cm (range: 16.1-20.1cm; SD 0.76). The first principal component (PC1) mainly modeled the ROI length, which correlated well with body height (r=0.325; p<0.001). PC1 comprised 47.4% of the overall ROI form variation. PC2 primarily influenced the ROI curvature in the anterior-posterior (inlet) view. Curvatures were more pronounced in female patients compared to males (p<0.001). There was no gender-specific ROI size variation. PC1-4 contained 80.2% of the total ROI form variation. Left and right ROI forms displayed symmetry.CONCLUSION: This 3D morphometric study demonstrates the feasibility of anatomical implants for minimally invasive acetabular fracture osteosynthesis. Implant size/length is by far the most important variable of form variation. The necessity of gender-specific implant forms requires further investigation. The non-fractured, contralateral hemipelvis can be used for preoperative surgical planning. Ultimately, the plate design will depend on prospective implant fit tests based on the required fit as defined by the clinician.

Resumo Limpo

troduct anatom implant enabl minim invas osteosynthesi mio repres ideal complement computerassist surgic workflow d morphometr studi analyz anatom implant form aif acetabular fractur osteosynthesi afomateri method threedimension pelvi model creat clinic ct data europeancaucasian patient femal male mean age patient year rang sd definit referenti region interest roi correspond aif afo follow autom roi comput hemipelvis threedimension statist model analysi result homolog roi consist thinplat spline transform general procrust fit princip compon analysisresult mean roi length cm rang cm sd first princip compon pc main model roi length correl well bodi height r p pc compris overal roi form variat pc primarili influenc roi curvatur anteriorposterior inlet view curvatur pronounc femal patient compar male p genderspecif roi size variat pc contain total roi form variat left right roi form display symmetryconclus d morphometr studi demonstr feasibl anatom implant minim invas acetabular fractur osteosynthesi implant sizelength far import variabl form variat necess genderspecif implant form requir investig nonfractur contralater hemipelvi can use preoper surgic plan ultim plate design will depend prospect implant fit test base requir fit defin clinician

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